Postoperative Pain in Tonsillectomy: Comparison of Ultrasonic Tonsillectomy versus Blunt Dissection Tonsillectomy

Abstract

Intraoperative blood loss, postoperative pain, and postoperative appetite were compared between 15 adult patients who underwent tonsillectomy using an ultrasonically activated scalpel (UT) and 15 adult patients who underwent blunt dissection tonsillectomy with cold steel instruments (BT). The average intraoperative blood loss of the UT group was 4.6 ± 1.9 ml (mean ± standard deviation), while that of BT group was 41.9 ± 12.9 ml. This difference was highly statistically significant (p < 0.0001). In contrast, there were no significant differences in the VAS pain and appetite scores between patients who underwent UT and those who underwent BT on any day in the 6-day postoperative period. Our current results show that UT is a safe technique, and we believe that it should be considered a useful alternative for tonsil surgery.

Ultrasonically Activated Scalpel Compared with Electrocautery in Tonsillectomy

“…The amount of blood loss during surgery is smaller with UAS [20,23]. According to a double-blind randomized trial by Kujawski et al [5], a microsurgical bipolar cautery tonsillectomy compares favorably with traditional blunt dissection tonsillectomy in terms of operative bleeding, postoperative pain, otalgia, and hemorrhage.…”

“…The use of UAS in tonsillectomy is associated with minimal operative bleeding [20,23], which however is a relative advantage and possibly due to longer operation duration [18]. Other methods of hemostasis, e.g.…”

Pediatric Tonsillotomy with the Radiofrequency Technique: Less Morbidity and Pain

“…They all appear to work well for the removal of the tonsils with less bleeding, but they do not reduce the postoperative pain as much. 3–6 However, if a partial intracapsular TE (tonsillotomy [TT]) is performed, the postoperative morbidity is remarkably reduced. 7,8 The tonsillar tissue per se does not appear to be as pain sensitive and heals rapidly after the surgery.…”

Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy

“…A recent study shows that currently about 50% of the American ENT specialists use one or another electrosurgical options for tonsillectomy [3]. These methods all seem to work well for the removal of the tonsils with less bleeding, but they do not necessarily reduce the post-operative pain [4][5][6][7].…”